MISSISSIPPI LEGISLATURE
2019 Regular Session
To: Public Health and Welfare
By: Senator(s) DeBar
AN ACT TO AMEND SECTION 73-15-3, MISSISSIPPI CODE OF 1972, TO INCLUDE ADVANCED PRACTICE REGISTERED NURSES IN THE STATEMENT OF PURPOSE OF THE MISSISSIPPI NURSING PRACTICE LAW; TO AMEND SECTION 73-15-5, MISSISSIPPI CODE OF 1972, TO DELETE CERTAIN DEFINITIONS AND REVISE CERTAIN DEFINITIONS IN THE NURSING PRACTICE LAW REGARDING ADVANCED NURSING PRACTICE; TO AMEND SECTION 73-15-20, MISSISSIPPI CODE OF 1972, TO REVISE CERTAIN PROVISIONS RELATING TO THE PRACTICE OF ADVANCED NURSING PRACTICE NURSES AND TO DELETE THE REQUIREMENT THAT ADVANCED PRACTICE REGISTERED NURSES PRACTICE IN A COLLABORATIVE/CONSULTATIVE RELATIONSHIP WITH A LICENSED PHYSICIAN; TO AMEND SECTION 73-15-29, MISSISSIPPI CODE OF 1972, TO INCLUDE ADVANCED PRACTICE REGISTERED NURSES IN THE PROVISIONS RELATING TO GROUNDS FOR DISCIPLINARY ACTIONS AGAINST NURSES; AND FOR RELATED PURPOSES.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:
SECTION 1. Section 73-15-3, Mississippi Code of 1972, is amended as follows:
73-15-3. In order to safeguard life and health, any person practicing or offering to practice as a registered nurse, an advanced practice registered nurse or a licensed practical nurse in Mississippi for compensation shall hereafter be required to submit evidence of qualifications to practice and shall be licensed or hold the privilege to practice as hereinafter provided. It shall be unlawful for any person not licensed or holding the privilege to practice under the provisions of this article:
(a) To practice or offer to practice as a registered nurse, an advanced practice registered nurse or a licensed practical nurse;
(b) To use a sign, card or device to indicate that such person is a registered nurse, an advanced practice registered nurse or a licensed practical nurse.
Any person offering to practice nursing in Mississippi must be licensed or otherwise authorized to practice as provided in this article.
SECTION 2. Section 73-15-5, Mississippi Code of 1972, is amended as follows:
73-15-5. (1) "Board" means the Mississippi Board of Nursing.
(2) The "practice of nursing" by a registered nurse means the performance for compensation of services which requires substantial knowledge of the biological, physical, behavioral, psychological and sociological sciences and of nursing theory as the basis for assessment, diagnosis, planning, intervention and evaluation in the promotion and maintenance of health; management of individuals' responses to illness, injury or infirmity; the restoration of optimum function; or the achievement of a dignified death. "Nursing practice" includes, but is not limited to, administration, teaching, counseling, delegation and supervision of nursing, and execution of the medical regimen, including the administration of medications and treatments prescribed by any licensed or legally authorized physician or dentist. The foregoing shall not be deemed to include acts of medical diagnosis or prescriptions of medical, therapeutic or corrective measures, except as may be set forth by rules and regulations promulgated and implemented by the Mississippi Board of Nursing.
* * *
( * * *3) "Advanced nursing
practice" means, in addition to the practice of professional nursing, the
performance of advanced-level nursing approved by the board which, by virtue of
graduate education and experience are appropriately performed by an advanced
practice registered nurse. The advanced practice registered nurse may
diagnose, treat and manage medical conditions. This may include prescriptive
authority as identified by the board. * * *
( * * *4) The "practice of nursing"
by a licensed practical nurse means the performance for compensation of
services requiring basic knowledge of the biological, physical, behavioral,
psychological and sociological sciences and of nursing procedures which do not
require the substantial skill, judgment and knowledge required of a registered
nurse. These services are performed under the direction of a registered nurse
or a licensed physician or licensed dentist and utilize standardized procedures
in the observation and care of the ill, injured and infirm; in the maintenance
of health; in action to safeguard life and health; and in the administration of
medications and treatments prescribed by any licensed physician or licensed
dentist authorized by state law to prescribe. On a selected basis, and within
safe limits, the role of the licensed practical nurse shall be expanded by the
board under its rule-making authority to more complex procedures and settings
commensurate with additional preparation and experience.
( * * *5) A "license" means an
authorization to practice nursing as a registered nurse, an advanced
practice registered nurse or a licensed practical nurse designated herein.
( * * *6) A "registered nurse" is a
person who is licensed or holds the privilege to practice under the provisions
of this article and who practices nursing as defined herein. "RN" is
the abbreviation for the title of Registered Nurse.
( * * *7) A "licensed practical
nurse" is a person who is licensed or holds the privilege to practice
under this article and who practices practical nursing as defined herein.
"LPN" is the abbreviation for the title of Licensed Practical Nurse.
( * * *8) A "registered nurse in
clinical practice" is one who functions in any health care delivery system
which provides nursing services.
* * *
(9) "Collaboration" or "collaborate" means the act of communicating pertinent information or consulting with a licensed physician or other licensed health care provider with each provider contributing the provider's respective expertise to optimize the overall care delivered to the patient.
( * * *10) An "advanced practice
registered nurse" is a person who is licensed or holds the privilege to
practice under this article as a professional nurse and who is * * * licensed as an advanced
practice registered nurse or specialized nursing practice and includes
certified registered nurse midwives, certified registered nurse anesthetists
and certified nurse practitioners. "CNM" is the abbreviation for the
title of Certified Nurse Midwife, "CRNA" is the abbreviation for the
title of Certified Registered Nurse Anesthetist. "CNP" is the
abbreviation for the title of Certified Nurse Practitioner.
( * * *11) A "nurse educator" is a
registered nurse who meets the criteria for faculty as set forth in a state-accredited
program of nursing for registered nurses, or a state-approved program of
nursing for licensed practical nurses, and who functions as a faculty member.
( * * *12) A "consumer
representative" is a person representing the interests of the general
public, who may use services of a health agency or health professional
organization or its members but who is neither a provider of health services,
nor employed in the health services field, nor holds a vested interest in the
provision of health services at any level, nor has an immediate family member
who holds vested interests in the provision of health services at any level.
( * * *13) "Privilege to practice"
means the multistate licensure privilege to practice nursing in the state as
described in the Nurse Licensure Compact provided for in Section 73-15-201.
( * * *14) "Licensee" is a person
who has been issued a license to practice nursing or advanced practice
nursing in the state or who holds the privilege to practice nursing in the
state.
SECTION 3. Section 73-15-20, Mississippi Code of 1972, is amended as follows:
73-15-20.
(1) Advanced practice registered nurses. Any nurse desiring to be * * * licensed as an advanced
practice registered nurse shall apply to the board and submit proof that he or
she holds a current license * * * as a
registered nurse and that he or she meets one or more of the following
requirements:
(a) Satisfactory completion of a formal post-basic educational program of at least one (1) academic year, the primary purpose of which is to prepare nurses for advanced or specialized practice.
(b)
Certification by a board-approved certifying body. Such certification shall be
required for initial state * * * licensure and any * * * licensure renewal as a certified
registered nurse anesthetist, certified nurse practitioner or certified
nurse midwife. The board may by rule provide for provisional or temporary
state * * *
licensure of graduate * * * advanced practice
registered nurses for a period of time determined to be appropriate for
preparing and passing the National Certification Examination. Those with
provisional or temporary * * *certifications licenses must practice under the direct
supervision of a licensed physician or * * *
an advanced practice registered nurse with at least five (5) years of
experience.
(c)
Graduation from a program leading to a master's or post-master's degree in a * * * program of study preparing for
one (1) of the described advanced practice registered nurse roles.
(2)
Rulemaking. The board shall provide by rule the appropriate
requirements for advanced practice registered nurses in the categories of
certified registered nurse anesthetist, certified nurse midwife and * * * certified
nurse practitioner.
* * *
( * * *3) Renewal. The board shall
renew a license for an advanced practice registered nurse upon receipt of the
renewal application * * *
and fees * * *. The board shall adopt rules
establishing procedures for license renewals. The board shall by rule
prescribe continuing education requirements for advanced practice registered
nurses * * * as a condition for renewal of * * * licensure.
( * * *4) Reinstatement. Advanced
practice registered nurses may reinstate a lapsed privilege to practice upon
submitting documentation of a current active license to practice professional
nursing, a reinstatement application and fee, * * *
documentation of current certification as an advanced practice registered
nurse in a designated area of practice by a national certification organization
recognized by the board and documentation of at least forty (40) hours of
continuing education related to the advanced clinical practice of the * * * advanced practice
registered nurse within the previous two-year period. The board shall
adopt rules establishing the procedure for reinstatement.
* * *
( * * *5) Practice requirements. The
advanced practice registered nurse shall practice as follows:
(a) Advanced practice registered nurses shall practice according to standards and guidelines of their respective professional organization and the National Certification Organization.
(b) * * * Advanced practice registered nurses shall collaborate
with other health care providers and refer or transfer patients as appropriate.
* * *
( * * *c) Advanced practice registered nurses
practicing as certified registered nurse anesthetists must practice
according to board-approved practice guidelines that address pre-anesthesia
preparation and evaluation; anesthesia induction, maintenance, and emergence;
post-anesthesia care; peri-anesthetic and clinical support functions.
* * *
( * * *d) * * * Advanced practice registered
nurses may not write prescriptions for, dispense or order the use of or
administration of any schedule of controlled substances except as contained in
this chapter.
( * * *6) Prescribing controlled
substances and medications. * * * Certified nurse midwives and certified nurse practitioners Advanced
practice registered nurses may apply for controlled substance prescriptive
authority after completing a board-approved educational program. * * *
Advanced practice registered nurses who have completed the program and
received prescription authority from the board may prescribe Schedules II-V.
The words "administer," "controlled substances" and
"ultimate user," shall have the same meaning as set forth in Section
41-29-105, unless the context otherwise requires. The board shall promulgate
rules governing prescribing of controlled substances, including distribution,
record keeping, drug maintenance, labeling and distribution requirements and prescription
guidelines for controlled substances and all medications. Prescribing any
controlled substance in violation of the rules promulgated by the board shall
constitute a violation of Section 73-15-29(1)(f), (k) and (l) and shall be
grounds for disciplinary action. The prescribing, administering or
distributing of any legend drug or other medication in violation of the rules
promulgated by the board shall constitute a violation of Section 73-15-29(1)(f),
(k) and (l) and shall be grounds for disciplinary action.
SECTION 4. Section 73-15-29, Mississippi Code of 1972, is amended as follows:
73-15-29. (1) The board shall have power to revoke, suspend or refuse to renew any license issued by the board, or to revoke or suspend any privilege to practice, or to deny an application for a license, or to fine, place on probation and/or discipline a licensee, in any manner specified in this article, upon proof that such person:
(a) Has committed fraud or deceit in securing or attempting to secure such license;
(b) Has been convicted of a felony, or a crime involving moral turpitude or has had accepted by a court a plea of nolo contendere to a felony or a crime involving moral turpitude (a certified copy of the judgment of the court of competent jurisdiction of such conviction or pleas shall be prima facie evidence of such conviction);
(c) Has negligently or willfully acted in a manner inconsistent with the health or safety of the persons under the licensee's care;
(d) Has had a license or privilege to practice as a registered nurse, an advanced practice registered nurse or a licensed practical nurse suspended or revoked in any jurisdiction, has voluntarily surrendered such license or privilege to practice in any jurisdiction, has been placed on probation as a registered nurse, advanced practice registered nurse or licensed practical nurse in any jurisdiction or has been placed under a disciplinary order(s) in any manner as a registered nurse, advanced practice registered nurse or licensed practical nurse in any jurisdiction, (a certified copy of the order of suspension, revocation, probation or disciplinary action shall be prima facie evidence of such action);
(e) Has negligently or willfully practiced nursing in a manner that fails to meet generally accepted standards of such nursing practice;
(f) Has negligently or willfully violated any order, rule or regulation of the board pertaining to nursing practice or licensure;
(g) Has falsified or in a repeatedly negligent manner made incorrect entries or failed to make essential entries on records;
(h) Is addicted to or dependent on alcohol or other habit-forming drugs or is a habitual user of narcotics, barbiturates, amphetamines, hallucinogens, or other drugs having similar effect, or has misappropriated any medication;
(i) Has a physical, mental or emotional condition that renders the licensee unable to perform nursing services or duties with reasonable skill and safety;
(j) Has engaged in any other conduct, whether of the same or of a different character from that specified in this article, that would constitute a crime as defined in Title 97 of the Mississippi Code of 1972, as now or hereafter amended, and that relates to such person's employment as a registered nurse or licensed practical nurse;
(k) Engages in conduct likely to deceive, defraud or harm the public;
(l) Engages in any unprofessional conduct as identified by the board in its rules;
(m) Has violated any provision of this article; or
(n) Violation(s) of the provisions of Sections 41-121-1 through 41-121-9 relating to deceptive advertisement by health care practitioners. This paragraph shall stand repealed on July 1, 2020.
(2) When the board finds any person unqualified because of any of the grounds set forth in subsection (1) of this section, it may enter an order imposing one or more of the following penalties:
(a) Denying application for a license or other authorization to practice nursing, advanced nursing practice or practical nursing;
(b) Administering a reprimand;
(c) Suspending or restricting the license or other authorization to practice as a registered nurse, advanced practice registered nurse or licensed practical nurse for up to two (2) years without review;
(d) Revoking the license or other authorization to practice nursing, advanced nursing practice or practical nursing;
(e) Requiring the disciplinee to submit to care, counseling or treatment by persons and/or agencies approved or designated by the board as a condition for initial, continued or renewed licensure or other authorization to practice nursing, advanced nursing practice or practical nursing;
(f) Requiring the disciplinee to participate in a program of education prescribed by the board as a condition for initial, continued or renewed licensure or other authorization to practice;
(g) Requiring the disciplinee to practice under the supervision of a registered nurse or advanced practice registered nurse for a specified period of time; or
(h) Imposing a fine not to exceed Five Hundred Dollars ($500.00).
(3) In addition to the grounds specified in subsection (1) of this section, the board shall be authorized to suspend the license or privilege to practice of any licensee for being out of compliance with an order for support, as defined in Section 93-11-153. The procedure for suspension of a license or privilege to practice for being out of compliance with an order for support, and the procedure for the reissuance or reinstatement of a license or privilege to practice suspended for that purpose, and the payment of any fees for the reissuance or reinstatement of a license or privilege to practice suspended for that purpose, shall be governed by Section 93-11-157 or 93-11-163, as the case may be. If there is any conflict between any provision of Section 93-11-157 or 93-11-163 and any provision of this article, the provisions of Section 93-11-157 or 93-11-163, as the case may be, shall control.
(4) If the public health, safety or welfare imperatively requires emergency action and the board incorporates a finding to that effect in an order, the board may order summary suspension of a license pending proceedings for revocation or other action. These proceedings shall be promptly instituted and determined by the board.
SECTION 5. This act shall take effect and be in force from and after July 1, 2019.